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🏋🏻‍♂️ Supreme wellBeing 🏋🏻‍♂️
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14
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1
Which of the following describes you?
Please pick one
Sofa Spud: What's a workout? I exercise rarely to never.
Fickle Pickle: I work out inconsistently; sometimes a few times a week, some weeks not at all.
Motivated Melon: I have a consistent fitness routine; I workout 3x or more per week.
Jacked Jackfruit: I take my fitness very seriously and participate in competitive or advanced training.
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2
Which of these is most true for you?
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Fitness Enthusiast: I see exercise as a key part of my identity and lifestyle.
Health-Conscious Individual: I exercise mainly to maintain my health and well-being.
Goal-Oriented Achiever: I work out to achieve specific fitness goals or milestones.
Social Exerciser: I enjoy exercising primarily for the social aspect and group activities.
Stress Reliever: I use exercise as a way to relieve stress and improve my mood.
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3
What diets or fitness programs have you tried in the past, and why do you think they didn’t work for you?
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Please describe briefly in the text box below.
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4
What do you believe are the biggest barriers to achieving your fitness goals?
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Choose all that apply
Lack of Time: I don't have enough time in my schedule to work out consistently.
Insufficient Knowledge: I’m unsure about how to create an effective workout or nutrition plan.
Low Motivation: I struggle to stay motivated and committed to my fitness routine.
Financial Constraints: I can't afford the necessary equipment, gym membership, or personal training services.
Unrealistic Goals: I feel my goals are too ambitious or unattainable.
Lack of Support: I don’t have enough support from friends, family, or a community to stay on track.
Past Failures: Previous attempts at fitness have failed, making me doubt my ability to succeed.
Self-Doubt: I don’t believe in my ability to achieve the results I want.
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5
Which of the following best describes your current dietary preference?
Pick One
Vegan/Vegetarian: I follow a plant-based diet, avoiding animal products or consuming minimal animal products.
Keto: I follow a high-fat, low-carb diet designed to put my body into a state of ketosis.
Paleo: I follow a diet based on eating whole foods similar to what might have been eaten during the Paleolithic era (e.g., lean meats, fish, fruits, vegetables, nuts).
Low-Carb: I limit my carbohydrate intake but don’t follow a strict keto diet.
Carnivore: I eat only animal products and avoid plant-based foods entirely.
Whatever: I don't really follow any preference, I eat what I want, when I want, and don't give much thought to nutrition
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6
What types of exercise do you prefer or enjoy the most?
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Choose your top 2-3
Cardio (e.g., running, cycling)
Flexibility (e.g., yoga, stretching)
Strength training (e.g., weightlifting, resistance exercises)
Sports (e.g., basketball, soccer)
Group fitness classes (e.g., aerobics, spin)
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7
Do you have any current or past health issues that affect your ability to exercise or follow a specific diet? (e.g., diabetes, heart conditions, joint problems)
If so, please specify
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8
What specific goals would you like to achieve through a fitness or nutrition program?
Choose all that apply
Losing weight or fat
Improving endurance or fitness levels
Gaining muscle or strength
Enhancing Overall Well-being
Developing healthier eating habits
Preparing for an event or goal
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9
I would rate my daily energy level as
Pick one from the drop down menu
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Very High
High
Average
Low
Very Low
Please Select
Please Select
Very High
High
Average
Low
Very Low
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10
How do you typically track your fitness and nutrition progress?
Pick one
Journaling or diary
Mobile apps or fitness trackers
Regular check-ins with a coach or trainer
Not tracking progress
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11
How do you typically handle setbacks or obstacles in your fitness or nutrition journey?
Please pick one
Seek support from others
Reevaluate and adjust my plan
Push through on my own
Feel discouraged and take a break
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12
What types of content do you find most engaging or helpful in fitness and nutrition programs?
Please choose 1-3
Practical tips and strategies
Scientific explanations and research
Success stories and testimonials
Interactive exercises or challenges
Visual content (e.g., videos, infographics)
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13
My name is...
What should we call you?
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14
Email
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Your best email so we can send you the results.
example@example.com
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